Frontal sinus stents: how long can they be kept in?

BACKGROUND: The frontal recess can be a difficult area to manage postoperatively as recurrent disease and stenosis may obstruct drainage of the frontal sinus. Frontal sinus stents may be used to maintain patency temporarily. We reviewed the outcomes of frontal sinus stents left in patients for longer than 3 months to determine how long a long-term frontal stent can be left in situ.

STUDY DESIGN: Retrospective chart review of patients who had frontal sinus stents in situ for 3 months or longer during a 6-year span.

METHODS: A retrospective review of patients who had frontal stents in situ longer than 3 months from April 2000 to March 2006. Eleven charts were reviewed.

RESULTS: Eleven patients had 21 frontal stents placed. Ten stents were still in situ at the end of the period studied. In the remaining 11 stents, the average duration of placement was 16.3 months. The spontaneous dislodgement rate was 14%, occurring at an average of 8.8 months. Irreversible obstruction, complication, and failure rates were 5%, 5%, and 9%, respectively.

CONCLUSIONS: In this series, long-term frontal stents (defined as those left in for longer than 3 months) have been safely left in situ for an average of 16.3 months. Benefits include relative ease of placement and good patient tolerance. Disadvantages include periodic stent replacement from dislodgement or obstruction, the occasional need for suctioning to maintain patency, and the potential for stent migration into the frontal sinus. One of 11 patients had a failure of symptom control, requiring additional frontal sinus surgery.